Do serrated neoplasms of the small intestine represent a distinct entity? Pathological findings and molecular alterations in a series of 13 cases

Rosty, Christophe, Campbell, Catherine, Clendenning, Mark, Bettington, Mark, Buchanan, Daniel D and Brown, Ian S (2015) Do serrated neoplasms of the small intestine represent a distinct entity? Pathological findings and molecular alterations in a series of 13 cases. Histopathology, 66 3: 333-342. doi:10.1111/his.12469


Author Rosty, Christophe
Campbell, Catherine
Clendenning, Mark
Bettington, Mark
Buchanan, Daniel D
Brown, Ian S
Title Do serrated neoplasms of the small intestine represent a distinct entity? Pathological findings and molecular alterations in a series of 13 cases
Journal name Histopathology   Check publisher's open access policy
ISSN 1365-2559
0309-0167
Publication date 2015-02
Year available 2014
Sub-type Article (original research)
DOI 10.1111/his.12469
Volume 66
Issue 3
Start page 333
End page 342
Total pages 10
Place of publication West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing Ltd
Collection year 2015
Language eng
Formatted abstract
Aims
To characterize pathological, immunohistochemical and molecular features of small intestinal serrated neoplasms.

Methods and results
We report 13 serrated neoplasms located predominantly in the duodenum (median age, 71 years; male to female ratio, 7:6). The serrated adenomas demonstrated prominent serration, ectopic crypt formations and cytological features reminiscent of colorectal traditional serrated adenomas. Almost half the serrated adenomas demonstrated high-grade dysplasia or were associated with an adenocarcinoma. Immunohistochemical and molecular analysis showed an intestinal (CDX2-positive) phenotype in all tumours, abnormal β-catenin staining in three cases (23%), abnormal p53 expression in four cases (31%), focal loss of MGMT expression in one case (8%), KRAS mutation in five cases (38%) and CpG island methylator phenotype in six cases (50%). A diffuse pattern of Ki67 expression was present in eight adenomas (62%) and was associated with high-grade dysplasia (P = 0.02). No BRAFV600E mutation or loss of MLH1 expression was observed.

Conclusions
To our knowledge, this is the first series reporting serrated adenoma in the small intestine, a rare subtype of adenomas resembling traditional serrated adenoma with aggressive morphological features. The absence of the BRAFV600E mutation does not support a role for the serrated neoplasia pathway in the development of these lesions, as in colorectal serrated polyps.
Keyword BRAF
CIMP
KRAS
Serrated adenocarcinoma
Serrated adenoma
Small intestine
Traditional serrated adenoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Official Audit
School of Medicine Publications
 
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